Digital Health Monitor – Pharmaceuticals

Home , Baxter International, Gilead Sciences

The 2018 Worldcom Digital Health Monitor – Pharmaceuticals

Drafted by Worldcom Healthcare May 2019 Table of contents

Section One Introduction...... 4

Section Two Research methodology...... 4

Criteria...... 6

Section Three Digital Healthcare Monitor Results...... 7

Results summary...... 8

Section Four Social media channels...... 10

Social media worldwide...... 10

Use of Facebook...... 11

Use of Twitter...... 12

Use of LinkedIn...... 13

Use of YouTube...... 14

Combined social channel ranking...... 15

Combined online and social ranking...... 16

Section Five Analysis of content...... 17

Top 25 words about pharma...... 17

Top 25 hashtags about pharma...... 18

About pharma versus by pharma...... 19

Sentiment...... 19

Messages per source – about the pharma sector...... 21

Messages per source – by the pharma sector...... 22

2 Table of contents

What else is being said about the pharma sector? Two issues...... 24

Twitter influencers ‘big pharma’...... 25

Appendix One Country-specific results...... 26

Overall top 25 Argentina...... 27

Overall top 25 Belgium...... 27

Overall top 25 Brazil...... 28

Overall top 25 Bulgaria...... 28

Overall top 25 Canada...... 29

Overall top 25 Colombia...... 29

Overall top 25 Dominican Republic...... 30

Overall top 25 Germany...... 30

Overall top 25 Hungary...... 31

Overall top 25 Ireland...... 31

Overall top 25 Italy...... 32

Overall top 25 The Netherlands...... 32

Overall top 25 Peru...... 33

Overall top 25 Poland...... 33

Overall top 25 South Africa...... 34

Overall top 25 Spain...... 34

Overall top 25 Thailand...... 35

Overall top 25 Turkey...... 35

Overall top 25 United Kingdom...... 36

Overall top 25 United States...... 36

Recommendations...... 37

About Worldcom...... 39

3 Section One Introduction

Pharmaceutical companies have been pushing back the boundaries of research, development and medical science for over a century. They are amongst the most innovative companies in the world. But, in this digital age, does their digital presence demonstrate the same innovative thinking?

Worldcom Healthcare decided to find out.

Section Two Research methodology

We selected 25 pharmaceutical companies based on their global reputation, their size and geographic presence. We analysed their online presence globally and in 20 countries, across 12 digital channels.

Pharmaceutical companies Countries Digital Channels

1. Abbott 1. Argentina 1. Website 2. Abbvie 2. Belgium 2. Blog 3. Allergan 3. Brazil 3. Apps 4. Amgen 4. Bulgaria 4. Facebook 5. Astellas Pharma 5. Canada 5. Twitter 6. AstraZeneca 6. Colombia 6. LinkedIn 7. Baxter International 7. Dominican Republic 7. YouTube 8. Bayer 8. Germany 8. Google+ 9. Biogen Idec 9. Hungary 9. Pinterest 10. Boehringer Ingelheim 10. Ireland 10. Flickr 11. Bristol-Myers Squibb 11. Italy 11. Instagram 12. Eli Lilly 12. The Netherlands 12. Tumblr 13. Gilead Sciences 13. Peru 14. GlaxoSmithKline 14. Poland 15. Johnson and Johnson 15. South Africa 16. Merck 16. Spain 17. Mylan 17. Thailand 18. Novartis 18. Turkey 19. Novo Nordisk 19. United Kingdom 20. Pfizer 20. United States 21. Roche 22. Sanofi 23. Shire 24. Takeda 25. Teva Pharmaceutical

4 Our analysis produced a Worldcom Healthcare monitor score for each company. This was based on each company’s presence on, or use of, the 12 channels, both internationally and on a country-specific level. A total of 428 points was available to each company - split between three web and nine social channels. So, for example, if a pharmaceutical company has a global Facebook page and a page for each of the 20 countries in the study, it was given 21 points.

Digital Monitor scores available

Digital Channel Max Score

Website 162.5

Web Blog 21 Apps 10 Total 196 Facebook 27 Twitter 27 LinkedIn 26 YouTube 26 Digital Channels Social Media Google+ 26 Pinterest 26 1. Website Flickr 25 2. Blog Instagram 25 3. Apps 4. Facebook Tumblr 24 5. Twitter Total 232 6. LinkedIn Grand Total 425.5 7. YouTube 8. Google+ 9. Pinterest We identified a range of criteria for each channel which can be seen in the charts below. The scores 10. Flickr produced by these criteria created the rankings that are listed throughout this document. 11. Instagram 12. Tumblr

5 Channel Criteria

Presence 1 Website Blog Apps Country specific page 1

International page 7,5 Presence 1 Presence 3 Country specific page 7,5 Country specific page 1 Availability 3 Cross device compatibility 5 HCP Utility 1 Patient Utility 1 Google+ Research/informative 1 Facebook If rated > 3 stars 1

Twitter

Presence 1 Country specific page 1 Page present 2 >10k followers 1 Country specific page 1 >50k followers 1 Use of integrated apps 1 >50k views 1 Presence 2 >10k likes 1 >3 updates/week 1 Country specific page 1 >50k likes 1 >7 updates/week 1 >10k followers 1 > 7 updates/week 1 >75k followers 1 Blog updates 1 >50% visual content 1 LinkedIn >3 tweets/day 1 >7 tweets/day 1 Instagram

YouTube

Presence 0,5 Country specific page 1

Presence 1 Presence on SlideShare 0,5 Country specific page 1 >10k followers 1 >100 followers 1 >50k followers 1 Presence 1 >200 followers 1 ≥5 updates/week 1 Country specific page 1 ≥1 update/4 weeks 1 > 50 followers on 1 Career channel 1 SlideShare >1 update/4 weeks 1 >2k subscribers 1 ≥5 slides shared 1 >10k subscribers 1 Flickr ≥1 update/2 weeks 1 Pinterest

Tumblr

Presence 1 Presence 1 Country specific page 1 Country specific page 1 >50 followers 1 Verified 1 Presence 1 >100 followers 1 >3 boards 1 Country specific page 1 ≥1 update/4 weeks 1 >10 boards 1 ≥1 update/4 weeks 1 >1 update/4 weeks 1 >200 followers 1 >1 update/4 weeks 1 >500 followers 1 ≥30 notes/posts 1

6 Section Three Digital Health Monitor Results

Digital Health Monitor - Overall Ranking As can be seen below, the top five digital performers are: Bayer, Pfizer, Boehringer Ingelheim, Novartis and Astra Zeneca.

The five lowest ranked are: Gilead Sciences, Shire, Teva Pharmaceutical, Mylan and Baxter International. Bayer scored 245.5 and Gilead scored 70.

Web Combined social Blog Apps (plus Google+ Company No. of Max. Max. Facebook Twitter LinkedIn YouTube Total Rank Alexa Pinterest country score score Traffic Flickr specific 21 10 Rank Instagram websites Tumblr)

Bayer 61.671 18 11 7 20 20 8 6 77 245.5 1 Pfizer 42.996 19 2 9 16 14 8 14 67 228 2 Boehringer 152.943 18 3 8 11 14 9 12 64 222.5 3 Ingelheim Novartis 70.235 17 2 10 7 12 10.5 7 55.5 202.5 4 Sanofi 104.899 18 1 8 9 11 7 8 49 198 5 AstraZeneca 52.172 16 3 5 7 18 6.5 5 52.5 196 6 GlaxoSmithKline 35.154 16 3 9 9 9 5.5 8 43.5 190 7 AbbVie 77.464 17 1 6 8 8 4 7 36 186 8 Johnson and 18.020 17 2 10 10 7 3.5 8 30.5 182.5 9 Johnson Roche 29.469 15 2 8 10 10 5.5 8 44.5 179.5 10 Eli Lilly 63.200 14 10 10 7 8 5.5 4 32.5 177.5 11 Novo Nordisk 149.682 15 2 8 5 9 2 5 38 173 12 Allergan 157.013 17 2 6 3 5 3.5 2 20.5 171.5 13 Takeda 109.447 16 2 8 5 4 8.5 6 28.5 171 14 Abbott 36.681 14 2 7 6 5 5 6 35 164.5 15 Biogen Idec 209.565 16 2 9 4 6 3.5 2 18.5 162 16 Merck 57.654 14 2 0 9 8 8.5 5 39.5 159 17 Bristol-Myers 68.143 15 1 9 6 7 3.5 4 22.5 157.5 18 Squibb Astellas Pharma 142.295 15 2 5 4 6 4.5 2 20.5 155.5 19 Amgen 85.836 13 2 6 3 8 5 5 29 150 20 Baxter 162.814 14 2 6 5 5 4.5 2 17.5 146 21 International Mylan 199.626 15 2 0 1 6 6 3 18 145 22 Teva 283.296 13 0 8 5 6 3.5 3 23.5 141.5 23 Pharmaceutical Shire 201.518 8 0 8 1 4 4.5 3 16.5 97 24 Gilead Sciences 157.560 5 0 8 3 6 5 2 17 70 25

7 Results summary Website All the pharmaceuticals have a global website, as can be expected from a multinational company. However, although local content is generally considered of great importance, many pharmaceuticals do not feed all the researched countries with local content.

Blogs Our analysis shows that the pharma companies make very little use of the power of blogs. Admittedly, almost all pharmacists report having a ‘global blog’, but local blogs are almost impossible to discover. Also, the number of blogs posted is quite moderate.

Apps Most companies have efficient, target group-centred apps. Except for two companies, the pharmaceuticals score 50% or more in this category.

Social media All pharmaceuticals but two have international Facebook accounts. Despite the fact that the number of Facebook users worldwide is much bigger, all pharmaceuticals on our list do have an international Twitter account.

LinkedIn accounts are present, but no pharmaceutical company achieves even 50% of the score. This is mainly due to the fact that country-specific pages on LinkedIn are apparently not common in the pharmaceutical sector.

Given the importance of YouTube, it is surprising that this platform does not seem to belong to the standard communications arsenal of pharmaceutical companies. Local YouTube accounts are available in only a handful of countries.

The use of the remaining channels, i.e. Google+, Pinterest, Flickr, Instagram, and Tumblr has proved to be so low among our pharmaceutical companies that it is of little use to discuss them separately.

Content – about the pharma sector In 2018, around 38,000 messages have been put online ‘About the pharma sector’. Not surprisingly, given the reputation of the average pharmaceutical company: what is said about the sector is not always positive. In a nutshell, the pharmaceutical companies tweet and post about their company, their congresses and campaigns, the disorders they treat and general health issues. The people who do not officially communicate on behalf of the pharmaceutical companies also talk about conspiracies and other possible abuses in pharmacy. Nonetheless, the general sentiment is not clearly negative. Twitter is the number 1 channel to talk about the pharma sector.

Content – by the pharma sector Our 25 pharmaceutical companies have put more than 25,000 messages online, mainly using Twitter and Facebook. A very striking fact is that YouTube and Instagram, respectively the second and sixth largest social channels globally, are heavily underrepresented.

Issues Issues that generate a lot of attention or an increasing amount of posts and tweets are ‘big pharma’ and ‘opioid abuse’, respectively. In 2018 no less than 66,000 posts were distributed in which ”big pharma” is mentioned. Most of the messages (77%) can be found on Twitter.

8 Section Four Channel Specific Rankings Overall online presence

Global Website As can be expected from multinationals in the pharmaceuticals industry, all companies have an international website. We assessed the impact of the websites using the Alexa Traffic Rank.

Alexa calculates the worldwide ranking of sites by relating the average number of daily visitors to the number of page views over a period of three months. The site that scores highest on the combination of ‘visitors’ and ‘page views’ is number one on the list. As a result, the smaller the number, the higher the ranking. The current global top five websites on the Alexa ranking, are: Google, YouTube, Facebook, Baidu and Wikipedia. We do not expect pharmaceutical firms to attract high volumes of visits, but you will see from the ranking chart above that there is a very wide range to the Alexa ranking. Johnson & Johnson has the highest ranking of 18.020 and Teva Pharmaceuticals has the lowest ranking of 283.296.

Country-specific websites The number of country-specific websites that the pharmaceuticals host does not vary a lot between the participants, except for Gilead Sciences and Shire.

The majority of pharmaceutical companies seem to recognize the importance of local content. Pfizer, for example, only lacks a country-specific site in the Dominican Republic. Gilead and Shire both underperform on this criterion, scoring only 25% and 40%, respectively.

Blog Our analysis shows that very little use is being made of blogs on these websites. Almost all the companies have a ‘global blog’, but local blogs are very rare. Only Bayer and Eli Lilly, have local blogs - and scored 11 and 10 points out of 21, respectively.

Without exception, the other pharmaceuticals do not score more than three points.

Apps The apps issued by the pharmaceutical companies have been scored on the basis of their Presence (three points), their Availability (three points), their Professional Utility (HCP Utility, one point), their Patient Utility, one point), their Information Value (Research/ informative, one point), and their Popularity (If rated > three stars, one point).

App-wise, our research population is generally well-established. All but two of the companies score 50% or more in this category.

9 Social media channels We analysed the social media behaviour of the 25 pharmaceutical companies by using the monitoring tool OBI4Wan. We also used the 2018 reports and overviews from We Are Social and Hootsuite and referred to statista.com.

Internet and social media use - a lost opportunity for the pharma industry The industry reports we used show that the pharma industry has not yet woken up to the opportunity provided by social channels to educate and inform its audiences and to build a brand following. While we recognize that the pharmaceutical sector is heavily regulated and therefore the way companies communicate with its various target audiences will be very different to consumer organizations, the Digital Monitor shows, that many companies may be squandering opportunities to get their messages across.

The number of worldwide Internet users now exceeds four billion. This means more than half of the world’s population uses the Internet. These users spent more time online than ever before. The average user now spends about six hours a day searching, surfing, chatting, watching, listening and interacting on the Internet. This means that the world population spent one billion years online in 2018.

The growth of Internet users in recent years is largely due to more affordable smartphones and mobile data. Two-thirds of the 7.6 billion inhabitants of the planet now have a mobile phone. Moreover, more than half of those are smart devices. Accessing the Internet is becoming easier for everyone, regardless of time and location.

Social media worldwide The use of social media also continues to grow. More than three billion people around the world now use social media every month. Almost all of them have access to these platforms through their mobile devices.

In October 2018, Facebook was the most popular channel worldwide with over two billion users - representing a big lead over YouTube. However, channel usage continues to evolve very fast, so we expect to see some big improvements in the next Worldcom Digital Health Monitor.

In October 2018, the figures were as follows:

Number of worldwide users of social channels

Number of users Number of users Company Company (in millions) (in millions) Facebook 2.234 Reddit 330 YouTube 1.900 LinkedIn 303 WhatsApp 1.500 Baidu tieba 300 Facebook Messenger 1.300 Skype 300 WeChat 1.058 Snapchat 291 Instagram 1.000 Viber* 260 Qq 803 Pinterest 250 Tumblr 794 Line 203 Qzone 548 Telegram 200 Douyin/Tik Tok 500 Yy 117 Sina weibo 431 Vkontakte 97 Google+ 395 Bbm 63 Twitter 335 Kakaotalk 49

The channels marked blue are so-called ‘social networks’, the ones marked white are ‘messenger apps’, chat apps or VoIP-applications.

10 Use of social media channels

We have ranked the 25 companies for their use of each of the nine social channels.

Use of Facebook Facebook

As can be seen from the chart below, the companies seem to have very different attitudes to Facebook. Bayer scores 20 points but Mylan and Shire did not have a ‘global’ Facebook page in 2018 and scored just one point each. Mylan did have a Hungarian Facebook page, which does raise questions about social media policies and Page present 2 procedures. Country specific page 1 We have rated the companies in accordance with the following Use of integrated apps 1 Facebook criteria: (see right) >10k likes 1 >50k likes 1 > 7 updates/week 1 Blog updates 1

Digital Health Monitor Facebook Ranking

20 20

16 16

12 11 10 10 10 Score 9 9 9 8 8 7 7 7 6 6 6 5 5 5 5 4 4 4 ie 3 3 3 Shir e Myla n Merck Roche Sanof i Abbot t AbbV Eli Lill y Novarti s 2 keda Baye r AstraZeneca Pfize r Ta GlaxoSmithKline Boehringer Ingelhei m Novo Nordisk 1 1 Amgen Bristol-Myers Squib b eva Pharmaceutica l Johnson and Biogen Idec Baxter Internationa l Gilead Sciences Allerga n Astellas Pharma 0 T 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank

11 Use of Twitter Twitter Twitter has 335 million users worldwide. Despite the fact that the number of Facebook users worldwide is much greater, all pharmaceuticals on our list do have an international Twitter account.

We have scored the Twitter activities as follows: (see right)

Presence 2 Here, too, Bayer is the leader of the pack and Shire the joint lowest scorer. Pfizer is in fourth place - demonstrating it prioritizes Facebook Country specific page 1 over Twitter. AstraZeneca, on the other hand, is in second for Twitter >10k followers 1 and only 10th for Facebook. >75k followers 1 >50% visual content 1 >3 tweets/day 1 >7 tweets/day 1

Digital Health Monitor Twitter Ranking

20 20

18 18

14 14 14

12 12 11 10 10 Score 9 9 8 8 8 8 8 7 7 6 6 6 6 6 6 5 5 5 4 4 4 ie Pfize r Mylan Bayer Merck Roch e Sanofi Amge n AbbV Eli Lill y Novartis ked a Abbott Allergan Biogen Idec

2 AstraZenec a Novo Nordisk Ta Shir e Gilead Science s Astellas Pharma GlaxoSmithKlin e eva Pharmaceutica l Boehringer Ingelheim Bristol-Myers Squibb T Johnson and Baxter Internationa l 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank

12 Use of LinkedIn LinkedIn Although LinkedIn reports 590 million users worldwide, many of which may be professional targets, the use of LinkedIn is much less than some of the other channels. The number one ranked company only scores just over 10 points out of a possible 27. This is predominantly due to the limited use of country-specific LinkedIn pages. However, as over half of users - 154 million - come from the US, it may make sense to adopt Presence 0,5 a global approach. India, China, Brazil and the UK also have high Country specific page 1 membership levels. So it may make sense to have a more local focus Presence on SlideShare 0,5 in these countries. Europe has 102 million users, so a regional >10k followers 1 approach should be considered. >50k followers 1 ≥5 updates/week 1 LinkedIn scores are based on the following: (see right) > 50 followers on SlideShare 1 ≥5 slides shared 1

Digital Health Monitor Twitter Ranking Based on these criteria, the companies ranked as follows:

10.5 10

9 8.5 8.5 8 8 8

7 6.5 6 6 5.5 Score 5.5 5.5 5 5 5 4.5 4.5 4.5 4 4 m 3.5 3.5 3.5 3.5 3.5 n a

2 ie 2 keda Shir e Pfize r Myla n Bayer Merck Roch e Sanofi Abbott Eli Lily Amgen AbbV Ta Allergan Novartis Biogen Idec AstraZenec eva Pharmaceutical Gilead Sciences Astellas Pharma Boehringer Ingelhei GlaxoSmithKline T Bristol-Myers Squibb Johnson and Johnso Novo Nordis k 0 Baxter Internationa l 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank

LinkedIn, number of users in millions

For once, Bayer does not take first place but appears in fifth. Novartis is the top-ranked firm followed by Boehringer Ingelheim. Novo Nordisk is the lowest-ranked with Shire moving into a mid-table position, albeit with just over four points.

13 Use of YouTube YouTube After Facebook, YouTube is the largest social platform worldwide and the world’s second largest search engine. The importance of YouTube is expected to increase, as visual content, particularly video, is preferred to text - even by business users.

The pharmaceutical companies were ranked by using the Presence 1 following criteria: Country specific page 1 Career channel 1 >2k subscribers 1 >10k subscribers 1 Digital Health Monitor YouTube Ranking ≥1 update/2 weeks 1 Based on these criteria, the companies ranked as follows:

14 14

12 12

8 8 8 8 8 Score 7 7 6 6 6 6 5 5 5 5 4 4 4

ie 3 3 3 ked a Pfizer Bayer Merck Roch e Sanofi Abbott Ta Amge n 2 AbbV 2 2 Novarti s 2 2 2 Eli Lill y AstraZeneca Novo Nordis k Shir e Mylan GlaxoSmithKlin e Boehringer Ingelhei m va Pharmaceutical Johnson and Bristol-Myers Squibb Te Gilead Sciences Allergan Baxter Internationa l Biogen Idec 0 Astellas Pharma 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank Pfizer tops the rankings with a score of 14. Boehringer Ingelheim is a close second but then the scores drop down significantly. Four of the sample scored just two points.

Most of the companies had little or no local YouTube presence. While the international language of pharma is English, it makes sense, for some audiences, to have local language content to encourage people to engage with the brand and to ensure there is no misunderstanding of what is being communicated.

YouTube statistics • Total number of daily active YouTube users: 30+ million • Number of videos shared to date: 5+ billion • Number of users creating content shared to date: 50 million YouTube can be used to attract the best talent. • Average viewing session: 40 minutes, up 50% year-over- So, not doing so represents a competitive year disadvantage as YouTube is particularity • Number of videos watched per day: 5 billion influential with Millennials and increasingly with • Number of mobile YouTube views per day: 500 million the 35+ and 55+ age groups. • Number of videos uploaded per minute: 300 hours • 80% of YouTube users come from outside the U.S • 35+ and 55+ age groups are the fastest-growing YouTube • demographics • Millennials prefer YouTube two to one over traditional • television • YouTube services 88 countries in 76 languages 14 Combined social channel ranking The remaining channels are: Google+, Pinterest, Flickr, Instagram, and Tumblr. Our analysis showed that the use of these channels by pharmaceutical companies is so low that it does not make sense to provide separate analysis.

Instead, we have compiled an ‘overall social top 25’ based on the scores across all nine social channels.

As can be seen in the chart below, Bayer tops the rankings with a score of 77 out of an available 232 points. Bayer is closely followed by Pfizer and Boehringer Ingelheim. Shire comes last in the ranking with a score that shows it is relatively inactive on social channels.

100

80 77

70 67 64 60 55.5 52.5 50 49 Score 44.5 44.5 40 39.5 38 36 35 32.5 30.5 30 29 28.5 23.5 22.5 20.5 20.5 20 18.5 18 17.5 17 16.5 ie

10 keda Pfizer Mylan Baye r Merck Roch e Sanofi Abbott Shir e Ta Amgen AbbV Eli Lilly Allergan Novarti s Boehringer Ingelheim Novo Nordisk GlaxoSmithKline AstraZeneca Johnson and eva Pharmaceutical Astellas Pharma Biogen Idec Gilead Sciences Baxter Internationa l Bristol-Myers Squib b 0 T 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank

Although not all channels will be applicable to all pharma companies, it makes sense to create an integrated global social communications strategy to ensure that opportunities are not being missed. For example, Worldcom’s Confidence Index demonstrated that attracting, retaining and energizing employees will be a key battleground for all organizations. Social channels will play a very important role in winning that battle for talent.

15 Combined online and social ranking In Section Three above we identified the leaders and followers in the Worldcom Digital Health Monitor. The chart below summarizes the ranking positions with a total score for all 12 channels analysed.

260 245.5 240 228 220 222.5

202.5 200 198 196 190 186 182.5 180 179.5 177.5 173 171.5 171 164.5 162 160 159 157.5 155.5 150 146 145 140 141.5

120

100 97

80 70 60 ie 40 akeda Shir e Pfizer Myla n Baye r Merc k Roche Sanof i Abbot t T Amgen AbbV Eli Lill y Allergan Novartis Biogen Idec AstraZeneca Novo Nordisk

20 Astellas Pharm a GlaxoSmithKline eva Pharmaceutica l Baxter Internationa l Gilead Sciences T Bristol-Myers Squib b Boehringer Ingelhei m Johnson and 0

16 Section Five Analysis of content

In addition to identifying which channels are being used, we wanted to understand what kind of messages were being conveyed about pharma companies. To do this we used a tool called OB14Wan to carry out a Boolean search in English for occasions when “pharmaceutical company”, “pharmaceutical companies”, “pharma company”, “pharma companies”, “pharma sector “ or “pharmaceutical sector was mentioned. It was important to search on this basis so that only relevant posts were identified. eW could have searched for terms like drugs, but that would have brought back thousands of irrelevant messages. 38,000 posts were identified with these core references. The content of these posts was then analysed further.

The analysis of the conversations about the pharma sector yields the following word cloud and hashtag cloud which show the most commonly occurring words and hashtags.

Top 25 words about pharma

The word cloud shows which words are most commonly used in the conversation about pharma. We have ignored words like ‘the’, ‘and’ and ‘that’ for the purposes of this research. as you can see from the list the most commonly occurring words are relatively generic. The words used tell a slightly different story.

Rank Word Occurrences in 2018 Rank Word Occurrences in 2018 1 pharmaceutical 6.006 14 michael 552 2 pharma 4.154 15 people 543 3 companies 3.815 16 brexit 541 4 drug 2.814 17 cell 530 5 market 1.390 18 100,000 516 6 payer 898 19 treatments 497 7 company 867 20 medicine 478 8 grandfather 842 21 novartis 458 9 filmed 832 22 antibiotics 442 10 cohen 819 23 may 422 11 medicines 765 24 damaging 413 12 health 636 25 fara 411 13 fda 568

17 Top 25 hashtags about pharma

The hashtag cloud shows which words the sender of the message wants to be associated with and therefore expects to be searched for by others. It also introduces a very different tone than the word cloud, with hashtags such as #corruption and #bribery featuring highly. This indicates the need for pharma companies to review the various channels for crisis and reputation management purposes

Rank Hashtag Occurrences 1 #pharma 1.491 2 #corruption 596 3 #bribery 559 4 #pharmaceutical 412 5 #r4today 320 6 #banklobbyistact 267 7 #scotus 201 8 #corybooker 201 9 #butterfly 183 10 #bigpharma 180 11 #healthcare 151 12 #antibiotics 145 13 #amr 141 14 #goptaxscam 138 15 #merck 127 16 #cybersecurity 123 17 #antibioticresistance 123 18 #pfizer 118 19 #lifesciences 115 20 #glaadawards 112

18 ‘About pharma’ versus ‘by pharma’

We decided to delve a little deeper by separating what is said about the sector from what the pharmaceutical companies talk about. The differences can be seen in the chart below.

The pharmaceutical companies tweet and post about their company (#jnj), their conferences (# asco18) and campaigns (#inventingforlife), the disorders they treat (#breastcancer) and general health issues (#biosimilars, #digitalhealth).

People who do not communicate on behalf of the pharmaceutical companies also talk about more negative topics such as: conspiracies (#goptaxscam), and other possible abuses in pharma (#bigpharma, #corruption, #bribery). They also talk about big issues such as #stopsuperbugs.

Sentiment We also looked at the sentiment of the 38,000 messages. While the sentiment assessment of a monitoring tool is still not comparable to those of a human being, it shows that the general tone of posts is neutral. In fact, 87% is marked as neutral by the tool, 11% as negative and 2% as positive.

Earlier in the report, we mentioned the lack of career channels on YouTube. If for example, advocate employees were encouraged to share their positive experiences, the positive sentiment score could improve significantly.

19 About pharma # Occurrences By pharma # Occurrences 1 #pharma 1.491 #jnj 1.093 2 #corruption 596 #cancer 520 3 #bribery 559 #landdergesundheit 479 4 #pharmaceutical 412 #digitalisierung 449 5 #r4today 320 #diabetes 417 6 #banklobbyistact 267 #hiv 394 7 #scotus 201 #dyk 344 8 #corybooker 201 #lungcancer 344 9 #butterfly 183 #stem 304 10 #bigpharma 180 #asco18 297 11 #healthcare 151 #amgen 273 12 #antibiotics 145 #digitalhealth 269 13 #amr 141 #lifetothefullest 250 14 #goptaxscam 138 #amgenonco 203 15 #merck 127 #erscongress 171 16 #cybersecurity 123 #lcsm 171 17 #antibioticresistance 123 #ms 169 18 #pfizer 118 #behindthescience 155 19 #lifesciences 115 #alzheimers 154 20 #glaadawards 112 #worldcancerday 154 21 #curatoken 111 #oncology 150 22 #ico 110 #italladdsup 149 23 #ethereum 108 #bio2018 145 24 #top50 107 #mmsm 144 25 #curaizon 107 #migraine 140 26 #stopsuperbugs 106 #gesundheit 133 27 #health 106 #biosimilars 126 28 #novartis 102 #obesity 125 29 #crypto 101 #ash18 124 30 #crowdfunding 98 #beteiligung 123 31 #bitcoin 96 #novartisnews 122 32 #shire 95 #sanofi 122 33 #fmqs 95 #innovation 121 34 #biotech 92 #breastcancer 119 35 #scotlandisnow 91 #multiplemyeloma 119 36 #brexit 90 #abbottwmm 118 37 #medicareforall 89 #afib 115 38 #resist 81 #ehealth 115 39 #digital 81 #healthcare 115 40 #genetic 80 #ipf 110 41 #dataprivacy 79 #press 110 42 #curaserve 78 #biogen40 108 43 #ranking 75 #science 106 44 #companies 75 #ki 101 45 #nomoretaxdodging 74 #aacr18 100 46 #repealthetrumptax 73 #asthma 100 47 #roche 72 #inventingforlife 96 48 #fairtrade 71 #iwd2018 96 49 #supplychain 67 #myeloma 96 50 #ehealth 65 #esmo18 93

20 Messages per source – about the pharma sector Earlier in the report, we identified the different channels in use by pharma companies.e W looked at the source of the 38,000 messages analysed and Twitter was the dominant channel.

In fact, Twitter was the No. 1 channel, with 58%. News channels came next with18%, followed by blogs (10%) and then Facebook (9%). Building a more local presence for blogs and other channels could help to see an improved balance in positive messaging and education.

21 Messages per source – by the pharma sector

The 25 pharmaceutical companies have put more than 25,000 messages online, mainly using Twitter and Facebook. This highlights that YouTube - the world’s second largest search engine - is not being used to advantage - if only for recruitment and employer brand purposes.

Channel # messages % Twitter 23.325 90,4% The distribution of messages by the pharmaceutical Facebook 2.250 8,7% companies differs somewhat from the expectations Instagram 168 0,7% that were created in the first part of the report. See the Pinterest 36 0,2% results in the table to the left. Total 25.779

The very low number of Shire’s English posts may have to do with the fact that in 2018 the company was in the midst of a takeover with Takeda, which officially acquired the American pharmaceutical company in December 2018.

Company # messages Pfizer 4.002 Abbott 2.045 Sanofi 1.693 Roche 1.439 Amgen 1.376 Johnson & Johnson 1.310 AstraZeneca 1.237 Boehringer Ingelheim 1.224 GlaxoSmithKline 1.219 Novartis 1.164 Novo Nordisk 1.162 AbbVie 1.042 Merck 1.013 Bristol Myers Squibb 990 Takeda 831 Gilead Sciences 796 Biogen Idec 765 Mylan 624 Bayer 573 Astellas Pharma 529 Eli Lilly 392 Baxter International 336 Teva Pharmaceutical 19 Allergan 9 Shire 5 Total 25.795

A closer look at issues discussed online

If we zoom in on the more negative side of the pharmaceutical sector, which is inevitably discussed on social media and in traditional media, we see terms such as ‘big pharma’ and ‘opioid abuse’ trend across the year. The first issue has been discussed worldwide for years, the second is a major problem in the US and is gradually becoming more and more widespread in other countries as well.

‘Big Pharma’ is a term that refers to a conspiracy theory that relates to the pharmaceutical industry. Supporters of the conspiracy theory believe, amongst other things, that the pharmaceutical sector is responsible for the suppression of, in particular, natural medicines for cancer. The conspiracy theory goes beyond the sector to include hospitals, doctors, politicians, and the media, which are said to work together to make the population ill through vaccinations so that they can increase their wealth. More extreme views include the view that vaccinations would also be part of a depopulation program aimed at reducing the world population.

In 2018, 66,000 posts were distributed in which ”big pharma” is mentioned. As you can see from the message chart there were significant spikes in message volumes across the year.

Message frequency about ‘big pharma’

From these messages, the following word clouds and hashtag clouds can be produced.

Most occurring words about ‘big pharma’

23 Top 25 hashtags about ‘big pharma’

We identified the channels used to share these messages and Twitter has over three-quarters of the messages identified. However, there are also significant volumes of messages on Facebook and other channels, which demonstrates the need to continuously review the range of channels that need to be monitored.

Messages per source – about ‘big pharma’

24 Twitter influencers ‘big pharma’

Influencer Followers Following Messages We also looked at the levels of influence that the sources of Business 2.539.538 668 5 some of the messages had. The Wikileaks 2.535.903 5.686 2 table to the left shows the FortuneMagazine 1.876.039 541 6 number of followers for a range of Twitter influencers and the BW 774.396 408 11 volume of ‘big pharma’ thinkprogress 325.154 949 10 messages they issued. Qz 163.010 126 12 jojokejohn 123.565 127.910 16 It makes sense to identify the sources of messages and rank prweekuknews 58.745 646 4 them in terms of the impact they matthewherper 47.216 1.563 3 will have on brand reputation. rtv6 44.808 1.223 2 While some can be ignored Lawfirm_MA 16.553 16.788 10 others may need a different approach to ensure that cafepharma 14.314 138 4 unhelpful messaging is not HansLak 13.678 13.910 4 allowed to gain impetus. MedicalQuack 8.360 1.558 7 Sspencer 7.831 294 2 Truthglow 6.777 6.827 3 jobsinsciences 6.607 2.085 7 SIRELifeScience 4.542 1.551 4 takepartsocius 4.375 4.196 2 wolfiemouse 4.171 4.214 2 OccuWorld 4.048 660 10 vocnederland 3.841 2.001 2 Ppolitics 3.729 4.057 4 scopedbylarry 3.354 3.339 4 pinksky4U 2.678 2.888 6

25 Appendix One Country-specific results In order to calculate the country-specific results, we have added the local results to the points obtained in the ‘international categories’. This was decided because English is the primary language for the pharma and science sectors. Many pharmaceutical companies seem to communicate to a large extent (or exclusively) in English. Therefore, without the results of the global channels, we would give a distorted picture.

The total number of points that can be obtained per country per pharmaceutical company, including the ‘international scores’, is 93.

The separate results for each of the 20 counties in the Monitor are shown below.

Bayer ranks highest in 18 out of 20 countries - excluding Peru and Canada. Bayer’s highest score of 75 was in Brazil.

Novartis topped the rankings in Canada with a score of 60 and Pfizer ranked the highest in Peru with a score of 63. Overall, Novartis ranked third and Pfizer was ranked sixth.

Gilead Sciences ranks the lowest overall and was ranked lowest in 10 out of 20 countries. Mylan is the next lowest overall and had the lowest ranking in six out of 20 countries.

The United States had the most companies with scores of 60 or over. It also had the highest score for the lowest ranking company.

26 Digital ranking for Argentina

Bayer tops the rankings with 71 points out of an available 93. Boehringer, Novartis and GSK are the only other companies to score over 60 points.

Mylan is in last place with 25.5 points and Gilead is the only other company to score less than 30 points.

Digital Ranking for Argentina 80

70 71

64 63.5 61.5 60 58.5 57 55.5 55 54

50 50 49 48.5 48.5

44 43.5 42.5 42.5 40 40.5 Score 38.5 38 37 36.5 36

30 27.5 25.5

20 c ie aked a Shir e Pfize r Myla n Bayer Merc k Roch e Sanof i Abbott Amgen AbbV T Eli Lilly Allergan Novarti s Biogen Ide AstraZeneca

10 Novo Nordis k Gilead Sciences Astellas Pharma GlaxoSmithKline eva Pharmaceutical Baxter Internationa l T Bristol-Myers Squibb Boehringer Ingelheim Johnson and

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank

Digital ranking for Belgium

Bayer tops the rankings with 73 points out of an available 93. Boehringer, Novartis, GSK and Pfizer are the only other companies to score 60 points or more.

Gilead is in last place with 27.5 points and Shire is the only other company to score less than 30 points.

Digital Ranking for Belgium 80

73 70 66 63.5 61.5 60 60 58.5 55 54.5 53 50 49.5 48.5 47.5 45.5 45 44.5 44.5 43.5 43.5 43.5 40 39.5 Score 35 34 33 30

n 29 l 27.5 e

20 r ie aked a Shir e Pfizer Myla n Baye Merc k Roch e Sanof i Abbot t Amgen AbbV T Eli Lilly Allergan Novarti s Biogen Idec 10 AstraZeneca Novo Nordis k va Pharmaceutica Astellas Pharma GlaxoSmithKlin Gilead Sciences Baxter Internationa l Te Bristol-Myers Squibb Boehringer Ingelheim Johnson and Johnso 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank

27 Digital ranking for Brazil

Bayer tops the rankings with 75 points out of an available 93. Boehringer, AstraZeneca and GSK are the only other companies to score over 60 points.

Gilead is in last place with 27.5 points and is the only company to score less than 30 points.

Digital Ranking for Brazil 80 75 70 65 61.5 61.5 60 59.5 59 59 58.5 57.5 56.5 55

50 50 48.5 47 45.5 44.5 44 43.5 43.5 43.5 43.5 40 40.5 Score 36.5 33 30 n 27.5 m e a 20 r ie ked a Shir e Pfize r Myla n Baye Merc k Roch e Sanofi Abbott Amgen AbbV Ta Eli Lilly Allergan Novartis Biogen Idec 10 AstraZeneca Novo Nordis k Astellas Pharm GlaxoSmithKlin eva Pharmaceutical Baxter Internationa l T Gilead Sciences Bristol-Myers Squibb Boehringer Ingelhei Johnson and Johnso 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank

Digital ranking for Bulgaria

Bayer tops the rankings with 73 points out of an available 93. Boehringer, Novartis, AstraZeneca and GSK are the only other companies to score over 60 points.

Gilead is in last place with 27.5 points and Shire is the only other company to score less than 30 points.

Digital Ranking for Bulgaria 80

73 70 66 63.5 62.5 61.5 60 58.5 57.5 57 56 55 54.5

50 49 48.5 47 45.5 45 44.5 43.5 43.5 42.5 40 40.5 Score 35 33 30 n 29 27.5 a

20 y r ie akeda Shir e Pfize r Myla n Baye Merck Roch e Sanof i Abbott Amgen AbbV T Eli Lill Allergan Novarti s Biogen Idec 10 AstraZeneca Novo Nordis k va Pharmaceutical Astellas Pharm GlaxoSmithKline Baxter Internationa l Te Bristol-Myers Squibb Boehringer Ingelheim Gilead Sciences Johnson and Johnso 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank

28 Digital ranking for Canada

Novartis tops the rankings with 60 points out of an available 93. No other company reaches 60 points. Bayer, the company that tops 18 out of 20 rankings, only scores 51.5 points in Canada.

Gilead is in last place with 23.5 points and Shire is the only other company to score less than 30 points.

Digital Ranking for Canada 80

60 60 55 53 52.5 51.5 50 50 48 47 47 45 44 43 40 41 41

Score 37.5 37 37 36 35.5 35 34 30 31 30.5

n 29 m l 23.5 c

20 y ie aked a Shir e Pfize r Myla n Bayer Merc k Roch e Sanofi Abbott Amgen AbbV T Eli Lill Allergan Novartis Biogen Ide 10 AstraZeneca Novo Nordis k Astellas Pharma GlaxoSmithKline Baxter Internationa l va Pharmaceutica Bristol-Myers Squibb Boehringer Ingelhei Johnson and Johnso Te Gilead Sciences 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank

Digital ranking for Colombia

Bayer tops the rankings with 73 points out of an available 93. Novartis, AstraZeneca, GSK and Pfizer are the only other companies to score over 60 points.

Mylan is in last place with 25.5 points and Gilead is the only other company to score less than 30 points.

Digital Ranking for Colombia 80

73 70

62.5 61.5 61.5 61 60 59.5 59 56.5 55.5 51 50 50 48.5 48.5 45.5 44.5 44.5 44 43.5 43.5 42.5 40 38.5 38.5 Score 33 30 27.5 n l 25.5 a 20 y r ie ked a Shir e Pfizer Myla n Baye Merc k Roch e Sanof i Abbot t Amge n AbbV Ta Eli Lill Allergan 10 Novarti s Biogen Idec AstraZeneca Novo Nordis k Gilead Sciences va Pharmaceutica Astellas Pharm GlaxoSmithKline Baxter Internationa l Te Bristol-Myers Squibb Boehringer Ingelheim Johnson and Johnso 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank 29 Digital ranking for Dominican Republic

Bayer tops the rankings with 62.5 points out of an available 93. It is the only company to score over 60 points.

Mylan is in last place with 25.5 points. Gilead and Shire are the only other companies to score less than 30 points.

Digital Ranking for Dominican Republic 80

62.5 60 56.5 55 54 54 51 50 49 48.5 48.5 47.5 47 42.5 40 41 38.5 38 Score 37 36.5 36 36 35 35 33 30

n 29

m 27.5

e 25.5 a

20 y r ie ked a Shir e Pfize r Baye Merc k Roch e Sanof i Abbott Amgen AbbV Ta Eli Lill Allergan Novarti s Myla n Biogen Idec 10 AstraZeneca Novo Nordis k Astellas Pharm GlaxoSmithKlin Baxter Internationa l eva Pharmaceutical Bristol-Myers Squibb Boehringer Ingelhei Johnson and Johnso Gilead Sciences T 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank

Digital ranking for Germany

Bayer tops the rankings with 73 points out of an available 93. Boehringer, Novartis, AstraZeneca and GSK are the only other companies to score over 60 points.

Gilead is in last place with 27.5 points and Shire is the only other company to score less than 30 points.

Digital Ranking for Germany 80

73 70

66 65.5 64.5 62.5 60 60 59.5 57 56.5 55.5 55 52 50 48.5 48 47.5 47 46.5 45.5 44.5 44.5 43.5 40 40.5 Score 34 30

n 29

m 27.5 e

20 r ie keda Shir e Pfize r Myla n Baye Merck Roch e Sanofi Abbott Amgen AbbV Ta Eli Lilly Allergan Novarti s Biogen Idec 10 AstraZeneca Novo Nordis k Astellas Pharma GlaxoSmithKlin eva Pharmaceutical Baxter Internationa l T Gilead Sciences Bristol-Myers Squibb Boehringer Ingelhei Johnson and Johnso 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank 30 Digital ranking for Hungary

Bayer tops the rankings with 70 points out of an available 93. Boehringer, Novartis, AstraZeneca and GSK are the only other companies to score over 60 points.

Shire is in last place with 29 points and is the only company to score less than 30 points.

Digital Ranking for Hungary 80

70 70 64 62.5 61.5 61.5 60 59.5 56.5 56 55

50 49 48.5 47 46 44 43.5 43.5 42.5 41.5 40 41 38 Score 37 36 35 34 30 29 n l m e

20 y r ie aked a Shir e Pfize r Myla n Baye Merc k Roch e Sanofi Abbott Amgen AbbV T Eli Lill Allergan Novarti s Biogen Idec 10 AstraZeneca Novo Nordis k Gilead Sciences va Pharmaceutica Astellas Pharma GlaxoSmithKlin Baxter Internationa l Te Bristol-Myers Squibb Boehringer Ingelhei Johnson and Johnso 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank

Digital ranking for Ireland

Bayer tops the rankings with 67 points out of an available 93. Boehringer, Novartis and GSK are the only other companies to score over 60 points.

Gilead is in last place with 27.5 points and Shire is the only other company to score less than 30 points.

Digital Ranking for Ireland 80

70 67 64 62.5 61.5 60 59.5 59 56.5 54.5 52 51.5 50 49 48.5 47 45.5 44.5 44 43.5 42.5 42.5 40 40.5 39.5 Score 35 33.5 30 n 29 27.5 m e a

20 y r ie aked a Shir e Pfize r Myla n Baye Merck Roch e Sanof i Abbot t Amge n AbbV T Eli Lill Allergan Novarti s Biogen Idec 10 AstraZeneca Novo Nordis k Astellas Pharm GlaxoSmithKlin eva Pharmaceutical Baxter Internationa l Gilead Sciences T Bristol-Myers Squibb Boehringer Ingelhei Johnson and Johnso 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank 31 Digital ranking for Italy

Bayer tops the rankings with 71 points out of an available 93. Novartis, Pfizer, AstraZeneca, GSK, Boehringer and Roche all score over 60 points.

Mylan is in last place with 33 points.

Digital Ranking for Italy 80

70 71 68.5 65 64.5 64.5 64 60 60.5 59.5 57.5 56 56 54.5 53 50 49 48.5 47 46.5 45.5 44.5 43.5 43.5 41.5 40

Score 36 36 33 30 n e

20 r ie aked a Shir e Pfize r Myla n Baye Merc k Roch e Sanofi Abbot t Amge n AbbV T Eli Lilly Allergan Novarti s Biogen Idec 10 AstraZeneca Novo Nordis k Gilead Sciences Astellas Pharma GlaxoSmithKlin eva Pharmaceutical Baxter Internationa l T Bristol-Myers Squibb Boehringer Ingelheim Johnson and Johnso 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank

Digital ranking for The Netherlands

Bayer tops the rankings with 73 points out of an available 93. Boehringer, Novartis, AstraZeneca and GSK are the only other companies to score over 60 points.

Gilead is in last place with 27.5 points and Shire is the only other company to score less than 30 points.

Digital Ranking for The Netherlands 80

73 70 66 63.5 62.5 61.5 60 58.5 57.5 57 56 55 54.5

50 49 48.5 47 45.5 45 44.5 43.5 43.5 42.5 40 40.5 Score 35 33 30 29 27.5 m e a

20 y r ie akeda Shir e Pfize r Myla n Baye Merck Roch e Sanofi Abbott Amgen AbbV T Eli Lill Allergan Novarti s Biogen Idec 10 AstraZeneca Novo Nordis k va Pharmaceutical Astellas Pharm GlaxoSmithKlin Baxter Internationa l Te Bristol-Myers Squibb Boehringer Ingelhei Gilead Sciences Johnson and 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank

32 Digital ranking for Peru

Pfizer tops the rankings with 63 points out of an available 93. Bayer, Boehringer and Novartis are the only other companies to score 60 points or over.

Gilead is in last place with 27 points and Shire is the only other company to score less than 30 points.

Digital Ranking for Peru 80

63 61.5 61.5 60 60 58.5 54.5 54 54 50 50 49 48 47 45.5 41.5 40 40 38.5 Score 37 36 36 36 33 33 30 30 29 27 e

20 ie keda Shir e Pfize r Myla n Bayer Merc k Roch e Sanofi Abbott Amge n AbbV Ta Eli Lilly Allergan Novartis Biogen Idec 10 AstraZeneca Novo Nordis k Astellas Pharma GlaxoSmithKlin eva Pharmaceutical Baxter Internationa l T Bristol-Myers Squibb Gilead Sciences Boehringer Ingelheim Johnson and 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank

Digital ranking for Poland

Bayer tops the rankings with 70 points out of an available 93. Boehringer, Novartis, AstraZeneca and GSK are the only other companies to score over 60 points.

Shire is in last place with 29 points and is the only company to score less than 30 points.

Digital Ranking for Poland 80

70 70 64 62.5 61.5 61.5 60 58.5 56.5 56 56 55 54.5

50 49 48.5 46 45.5 44.5 44 43.5 43.5 42.5 42.5 40 40.5 Score 35 33 30 29 m e a

20 y r ie ked a Shir e Pfize r Myla n Baye Merc k Roch e Sanofi Abbott Amgen AbbV Ta Eli Lill Allergan Novarti s Biogen Idec 10 AstraZeneca Novo Nordis k Gilead Sciences Astellas Pharm GlaxoSmithKlin eva Pharmaceutical Baxter Internationa l T Bristol-Myers Squibb Boehringer Ingelhei Johnson and 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank 33 Digital ranking for South Africa

Bayer tops the rankings with 71 points out of an available 93. Boehringer, Novartis and AstraZeneca are the only other companies to score over 60 points.

Mylan is in last place with 25.5 points. Gilead and Shire are the only other companies to score less than 30 points.

Digital Ranking for South Africa 80

70 71

64 62.5 61.5 60 57 56.5 56 55.5 54 51 50 48.5 47.5 46.5

41.5 40 38.5

Score 37 43.5 36 36 35 35 33 30

n 29

m 27.5 25.5 a 20 r ie ked a Shir e Pfizer Myla n Baye Merc k Roch e Sanofi Abbot t Amgen AbbV Ta Eli Lilly Allergan Novarti s Biogen Idec 10 AstraZeneca Novo Nordis k Astellas Pharm GlaxoSmithKline eva Pharmaceutical Baxter Internationa l Gilead Sciences Bristol-Myers Squibb Boehringer Ingelhei T Johnson and Johnso 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank

Digital ranking for Spain

Bayer tops the rankings with 73 points out of an available 93. Boehringer, Novartis, AstraZeneca and GSK are the only other companies to score over 60 points.

Gilead is in last place with 27.5 points and is the only company to score less than 30 points.

Digital Ranking for Spain 80

73 70 67 63.5 62.5 61.5 60 58.5 57.5 57 56 56 54.5

50 50 49 48.5 45.5 45.5 44.5 44 43.5 43.5 43.5 42.5 40 Score 35.5 35 30

m 27.5 e

20 y r ie ked a Shir e Pfize r Myla n Baye Merck Roch e Sanofi Abbot t Amgen AbbV Ta Eli Lill Allergan Novarti s Biogen Idec 10 AstraZeneca Novo Nordis k va Pharmaceutical Astellas Pharma GlaxoSmithKlin Baxter Internationa l Gilead Sciences Te Bristol-Myers Squibb Boehringer Ingelhei Johnson and 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank 34 Digital ranking for Thailand

Bayer tops the rankings with 73 points out of an available 93. Boehringer, AstraZeneca and GSK are the only other companies to score over 60 points.

Gilead is in last place with 27.5 points and Shire is the only other company to score less than 30 points.

Digital Ranking for Thailand 80

73 70 66 62.5 61.5 60 58.5 56 56 56 54.5 50 50 49 48.5 47.5 46 44 43.5 42.5 42.5 40 40.5 38 Score 37 36 33 30 29

m 27.5 e

20 r ie keda Shir e Pfize r Myla n Baye Merck Roch e Sanofi Abbot t Amgen AbbV Ta Eli Lilly Allergan Novartis Biogen Idec 10 AstraZeneca Novo Nordis k Astellas Pharma GlaxoSmithKlin eva Pharmaceutical Baxter Internationa l T Bristol-Myers Squibb Gilead Sciences Boehringer Ingelhei Johnson and 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank

Digital ranking for Turkey

Bayer tops the rankings with 73 points out of an available 93. Boehringer, GSK, Novartis, AstraZeneca and Roche are the only other companies to score over 60 points.

Mylan is in last place with 25.5 points and is the only company to score less than 30 points.

Digital Ranking for Turkey 80

73 70 68 65.5 65.5 63.5 60.5 60 60 58.5 57 55 54.5 50 50 48.5 48 46 45.5 44.5 44.5 43.5 42.5 40 40.5 37.5 Score 36 35 30

m 25.5

20 r ie akeda Shir e Pfize r Myla n Baye Merc k Roch e Sanofi Abbot t Amgen AbbV T Eli Lilly Allergan Novartis Biogen Idec 10 AstraZeneca Novo Nordis k Gilead Sciences va Pharmaceutical Astellas Pharma GlaxoSmithKline Baxter Internationa l Te Bristol-Myers Squibb Boehringer Ingelhei Johnson and 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank 35 Digital ranking for United Kingdom

Bayer tops the rankings with 68 points out of an available 93. Boehringer is the only other company to score over 60 points.

Mylan is in last place with 25.5 points and Gilead is the only other company to score less than 30 points.

Digital Ranking for United Kingdom 80

70 68 66

60 59.5 58.5 57 55 55 54 53.5 52.5 52 50 51 50 48 46 46.5 45.5 42.5 42.5 40 38.5 37.5 Score 34 31 30 29 n 28.5 m e

20 r ie aked a Shir e Pfizer Myla n Baye Roch e Sanofi Merck Abbott Amge n AbbV T Eli Lilly Allergan Novartis Biogen Idec 10 AstraZeneca Novo Nordis k Astellas Pharma GlaxoSmith Klin eva Pharmaceutical Baxter Internationa l Gilead Sciences Bristol-MyersSquib b T Boehringer Ingelhei Johnson and Johnso 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank

Digital ranking for United States

Bayer tops the rankings with 71 points out of an available 93. More companies than in any other country score over 60 points. These are: Novartis, Boehringer, Merck, Pfizer, Roche, GSK, Sanofi, Johnson & Johnson and Abbott.

Baxter is in last place with 42.5 points, which is significantly higher than the lowest scores for other countries.

Digital Ranking for United States 80

70 71 70.5 69 68.5 68 66.5 65.5 63.5 62.5 62 60 59.5 59.5 59.5 54.5 54 52.5 51.5 50 50.5 50.5 49.5 47.5 46.5 46.5 44.5 42.5 40 Score

30 e

20 r ie akeda Shir e Pfizer Myla n Baye Merc k Roch e Sanofi Abbott Amge n AbbV T Eli Lilly Allergan Novarti s Biogen Idec 10 AstraZeneca Novo Nordis k Gilead Sciences Astellas Pharma GlaxoSmithKlin eva Pharmaceutical Baxter Internationa l T Bristol-Myers Squibb Boehringer Ingelheim Johnson and 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Rank 36 Section Six Recommendations

As healthcare communications professionals we appreciate that in such a highly regulated sector, the communications options open to pharmaceutical companies are severely limited compared to their peers in other markets. However, based on the analysis we have carried out, we offer the following recommendations for your consideration.

#1 Ensure that you have a careers channel on YouTube and that advocate employees post reviews of their experience

#2 Review your use of the digital channels most used by your target audiences and ensure that your brand is present at both a global and local level

#3 Compare your digital ‘footprint’ to that of your peers and competitors and ensure that you don’t lose ground by missing opportunities to share permitted information across all available channels. Remember, Bayer’s Digital Monitor Score was over three times as high as Gilead Sciences in last place.

#4 Demonstrate that you care about each local market by investing in local digital channels. The adage, actions speak louder than words, definitely applies when local audiences are assessing your commitment to their country and to their health.

#5 We are sure you will already be actively monitoring online conversations. Use this analysis to identify topics where it’s essential you have an opinion, and that you share that opinion on a proactive basis.

Access to free real-time data We hope you have found this report helpful. We would love to provide you with real-time data on a number of the subjects we discussed above. Our friends at OBI4Wan have enabled us to provide free and unlimited access to four narrow-casts. Just click on the links below.

NARROW CASTS: Real-time conversations about big pharma Real-time conversations about pharma pricing issues Real-time conversations about opioid and pharma Real-time conversations about the global pharma sector

I hope you find this information useful.

If you would like to be included in our next Digital Monitor or would like to discuss any of our findings, please contact Serge Beckers at [email protected]

Serge Beckers Managing Partner, Wisse Kommunikatie Worldcom Healthcare Group Chair

37 For a local discussion about your communications needs please contact the appropriate partner in the list below:

UNITED STATES HUNGARY Bliss Integrated Communication NYC Probako Communications Cerrell Associates, Inc Corporate Ink Integrated Marketing and PR INDIA Coyne Public Relations, LLC S.P.A.G - Strategic Partners Group DEVENEY Dick Jones Communications Dix & Eaton IRELAND Fusion Communications Keating & Associates IW Group Inc. Off Madison Ave ITALY Padilla BPRESS Public Communications Inc. RLF Communications JAPAN Sachs Media Group AZ.Worldcom Japan Co., Ltd. Sandy Hillman Communications Schneider Associates MALAYSIA CANADA TQPR Malaysia Casacom Montreal Enterprise Canada Inc. THE NETHERLANDS Wisse Kommunikatie UNITED KINGDOM JBP Associates NORWAY Kaizo PR Coxit Public Relations

GERMANY PERU HBI PR & Marcom Realidades S.A.C. komm.passion GmbH SOUTH AFRICA AUSTRALIA Meropa Communications Phillips Group SPAIN BELGIUM Grupo Albión InstiCOM SWITZERLAND BRAZIL L&W Communication PLANIN THAILAND BULGARIA TQPR Thailand Janev & Janev Ltd. TURKEY COLOMBIA OptimumBrand Grupo Albión Colombia VIETNAM FINLAND TQPR Vietnam Medita Communication

FRANCE Yucatan

38 About Worldcom

The Worldcom Group® was founded in 1951. Sixty-eight years later, Worldcom’s partners solve communications challenges for clients in 49 countries on six continents.

Worldcom’s 2000 plus communications professionals deliver immediate impact and sustained value through the intelligent use of communications – wherever in the world a client needs support. Present in 95 cities around the world, we are capable of delivering both global and local solutions.

For more information about how Worldcom can help you, please contact Managing Director Todd Lynch at [email protected]